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4926 Johnson Dr., Shawnee Mission, KS 66205
Office Hours: Monday-Friday 9-5
Available by phone 24/7
913-384-5566

Vital Statistics Form

Please fill this form out as much as possible. It will help us to complete the death certificate and in writing the obituary. All fields with an asterisk are required.

Deceased's Information

If residence, please include address
mm/dd/yyyy
English, Irish, French, German, etc.
Be specific
Primary occupation during working years. *Do not enter \"retired\".
Sales, Medical, Engineering, Construction, etc.
Please list survivors and relationship: son, daughter, brother, sister, etc.
Religious affiliations, fraternal and civic organizations, hobbies, etc.

Informant's Information

A copy of what is submitted will be sent to this email.
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Obituaries & Condolences

James Tylar Phipps

Dale Ann Taylor

Charlotte Catherine (Boley) Denesha

Eugene J. Golden

Eugene Zheng

Mary Knowles

Teresa Gilder

Robert B. “Bob” Boehm

Kevin D. Gilpin

Wauneita Marjorie Van Natta

Philip Salvador

John E. Boullear

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